University of Oulu

Marko P.O. Virtanen, Juhani Airaksinen, Matti Niemelä, Teemu Laakso, Annastiina Husso, Maina P. Jalava, Tuomas Tauriainen, Pasi Maaranen, Eeva-Maija Kinnunen, Sebastian Dahlbacka, Stefano Rosato, Mikko Savontaus, Tatu Juvonen, Mika Laine, Timo Mäkikallio, Antti Valtola, Peter Raivio, Markku Eskola, Fausto Biancari, Comparison of Survival of Transfemoral Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement for Aortic Stenosis in Low-Risk Patients Without Coronary Artery Disease, The American Journal of Cardiology, Volume 125, Issue 4, 2020, Pages 589-596, ISSN 0002-9149, https://doi.org/10.1016/j.amjcard.2019.11.002

Comparison of survival of transfemoral transcatheter aortic valve implantation versus surgical aortic valve replacement for aortic stenosis in low-risk patients without coronary artery disease

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Author: Virtanen, Marko P.O.1; Airaksinen, Juhani2; Niemelä, Matti3;
Organizations: 1Heart Hospital, Tampere University Hospital and Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
2Heart Center, Turku University Hospital and Department of Surgery, University of Turku, Turku, Finland
3Department of Internal Medicine, Oulu University Hospital, Oulu, Finland
4Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland
5Heart Center, Kuopio University Hospital, Kuopio, Finland
6Department of Surgery, Oulu University Hospital and Research Unit of Surgery, Anesthesia and Intensive Care, Faculty of Medicine, University of Oulu, Oulu, Finland
7National Centre of Global Health, Istituto Superiore di Sanità, Rome, Italy
Format: article
Version: accepted version
Access: embargoed
Persistent link: http://urn.fi/urn:nbn:fi-fe2020051229403
Language: English
Published: Elsevier, 2020
Publish Date: 2020-11-19
Description:

Abstract

Increasing data support transcatheter aortic valve implantation (TAVI) as a valid option over surgical aortic valve replacement (SAVR) in the treatment for severe aortic stenosis (AS) also in patients with low operative risk. However, limited data exist on the outcome of TAVI and SAVR in low-risk patients without coronary artery disease (CAD). The FinnValve registry included data on 6463 patients who underwent TAVI or SAVR with bioprosthesis between 2008 and 2017. Herein, we evaluated the outcome of low operative risk as defined by STS-PROM score <3% and absence of CAD, previous stroke and other relevant co-morbidities. Only patients who underwent TAVI with third-generation prostheses and SAVR with Perimount Magna Ease or Trifecta prostheses were included in this analysis. The primary endpoints were 30-day and 3-year all-cause mortality. Overall, 1,006 patients (175 TAVI patients and 831 SAVR patients) met the inclusion criteria of this analysis. Propensity score matching resulted in 140 pairs with similar baseline characteristics. Among these matched pairs, 30-day mortality was 2.1% in both TAVI and SAVR cohorts (p = 1.00) and 3-year mortality was 17.0% after TAVI and 14.6% after SAVR (p = 0.805). Lower rates of bleeding and atrial fibrillation, and shorter hospital stay were observed after TAVI. The need of new permanent pacemaker implantation and the incidence of early stroke did not differ between groups. In conclusion, TAVI using third-generation prostheses achieved similar early and mid-term survival compared with SAVR in low-risk patients without CAD.

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Series: The American journal of cardiology
ISSN: 0002-9149
ISSN-E: 0002-9149
ISSN-L: 0002-9149
Volume: 125
Issue: 4
Pages: 589 - 596
DOI: 10.1016/j.amjcard.2019.11.002
OADOI: https://oadoi.org/10.1016/j.amjcard.2019.11.002
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
3121 General medicine, internal medicine and other clinical medicine
Subjects:
Copyright information: © 2019 Elsevier Inc. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/.
  https://creativecommons.org/licenses/by-nc-nd/4.0/